The cold open features the song "Unsaid Undone" from David Duchovny's debut album Hell or Highwater.
Fox Mulder (David Duchovny) ties the Seavers case to a number of people who have tried to kill themselves after claiming they saw someone who looked exactly like them.
The agents meet a patient at a psychiatric hospital named Judy Poundstone (Karin Konoval), who has dissociative identity disorder.
Meanwhile, Scully meets with “Demon Judy”, an evil alter ego, who seems to be flinging chocolate pudding at the cell door.
Back at the motel, Scully has trouble sleeping wondering if Judy had a point about her advancing age and seeks comfort from Mulder, which turns physically romantic.
On her way to the hospital, Scully sees her double in the backseat of her car, but stays calm, calling the figure a "manifest psychic ideation."
In an interview, Hooks commented regarding not getting to direct for the original series, "I feel like I had missed something very significant and when it came back, I was really excited about that".
"[2] The episode includes main cast members David Duchovny and Gillian Anderson, while Mitch Pileggi does not appear.
The episode guest stars Karin Konoval–who played Madame Zelma in "Clyde Bruckman's Final Repose" and Mrs. Peacock in "Home" in the original series–who appears in a dual role as brother and sister characters Judy and Chucky Poundstone.